ADHD? ODD? BIPOLAR? How do you tell

[nukett]

I have a nine year old daughter who shows almost all of the symptoms of adhd. She is also defiant and aggressive with her
brother, this started about 1 1/2 yrs ago. She also has syncope
episodes when she gets upset.  We had everything checked out
with a cardiologist, no problems.  Her pediatrician put her on 15mg of Adderall (adderrall) XR, she was totally zombified, couldn't function.  Then we tried 5mg of Adderall (adderrall) XR, after 5 days on the medication, she put her own life in danger as well as mine. For no apparent reason.  Now the doctor wants to try Strattera 25mg (isn't that a high dose for a 62lb child) and says if this doesn't work, then maybe she's bipolar. I'm afraid to put her on Strattera, she is asthmatic and also takes Albuterol on occassion.  I hate having my daughter used as a guniea pig.  How do you tell ADHD? ODD? BIPOLAR? Please help!!!!! I want my daughter back.

[Kevin Kennedy, Ph.D.]

Re: Strattera, it is a reasonable thought since your daughter did not respond favorably to the psychostimulant. The dose you mention is fine, but care must be taken since your daughter uses albuterol. Albuterol can increase heart rate and blood pressure, and Strattera can potentiate both of these reactions - i.e., it can make the reactions more pronounced.

Diagnosis of any emotional or menatl disorder is performed by applying standard diagnostic criteria and, if diagnostic critera are met, ruling out other possible explanations for the symptoms. ADHD sometimes occurs without the presence of any additional conditions, but it also exists alongside other conditions (e.g., Mood Disorder, other Disruptive Behavior Disorders) in many patients. Be sure to discuss the issue of diagnosis with your daughters providers, and don't be hesitant to request information about symptoms and how a particular diagnosis is reached. It sounds like your providers are being pretty conservative in the treatment of your daughter - i.e., they are not rushing to prescribe a number of medications at once.

[kidcare]

My 12 yr. old son is ADHD and bipolar and with out meds he would be miserable and I would be more insane!  Try and get with a good child psychiatrists to help with the meds. because they are more up to date with medication for ADHD and bipolar disorder..or this is what I have found to be true.  Make sure it is someone who you feel comfortable with and that is willing to listen to your concerns.  Unfortunately, you may have to try alot of meds to find the the best one for your daughter.  Go on-line to bpkids.com(i think) or type in early-onset bipolar disorder and you will find several good sites.  Compare what you read here with info about ADHD and jot down what you see about your daughter. If you're daughter is in public school and does not have special education services, contact your special ed. director now!  She would be entitled to a 504 accomadation plan or an IEP.  You can find more info on this by going to Wrightslaw.com or any article about IDEA part B services.  The reason I'm telling you this, is that my son was an A & B student until last year..he started having behavior problems and his grades went down. He went from having 1 teacher to 3 and this was too much change for him. This year he has flunked all year and within the past month he has been suspended 2 times for not following directions and threatening to bust out windows and run away.  This all has to do with being bipolar and being pushed and pushed at school.  We have been experiencing hell at home since school started because of homework and the school was aware of this.  We met and decided to make him do all his work at school (if not done at home) he lost free time, had closed lunch and missed his exploratory periods.  He did go to afterschool program where he worked on academics and homework.  We..the school and parents set him up to blow up.  He had no break at school and all he wanted to do was not have to go to the afterschool program ( who could blame him).  This happened this week and that is why he blew up and threatened to leave.  I know this is alot of info, but I know I've not thought some things thru the way I should and I will probably do it again.  Find you a good support system and a way to take a break..this really helps.  Oh, by the way, my son fights with his 14 yr old sister all the time.   Good luck and I hope these sites will be helpful!!

[stirling]

How do you know if adha has turned in to bipolar? In a 13yr old boy?

[mompy]

My son had been diagnosed with AD/OD and was unmanageable. I discovered the book, Is This Your Child? by Doris Rapp. She has several other books including Is This Your Child's World? Go to: www.drrapp.org  The basic message is that there are a whole host of behaviors and phyiscal symptoms that could be caused by food intolerances and/or environmental allergies.  Check it out!

We found through elimination diets that our son's explosive/angry behavior was caused by corn products. Removing corn from his diet has given us our son back. We also questioned bipolar disorder and depression. There is some evidence of bipolar symptoms in my husband's family. I believe now these symptoms are/were probably undiagnosed food intolerances.

It is a lot of work to change your diet. We basically eat only whole foods. It beats dosing out the paxil everyday - trust me!

[kidcare]

It is hard to know when ADHD has or hasn't crossed over to bipolar disorder.  I guess being followed by one doctor for so long has helped cut to the chase.  I believe he has both disorders but there is a fine line sometime.  School expectations seemed to be the thing that brought out more of the bipolar side to my son.  He was expected to do more but he had a hard time keeping it all together.  This is when the behavior problems at school then home started.  Just observe your child and note what's going on with them.

[stirling]

What kind of meds is you son on and how are they working?

[kidcare]

My son takes in am Focalin 15mg, Depakote 250mg, Lamictal 25mg, lithobid 300mg and just this week we started Abilify 10mg in am.  He takes Focalin 2 more times during day and at night he takes 2 Depakote, and we just decreased Zyprexa to half of 7.5 in pm.  Hopefully we will get rid of Zyprexa.  The Depakote we increased about 1 month ago due to his weight gain from Zyprexa. He can be easily agitated and become very agitated over little things.  Last week, it was over cheesecake..the fact that he wanted some and we didn't have any.  He threw stuff all over living room, went outside and picked up golf clubs, axe, etc. Almost 2 hours later he was eating and acted like nothing had happened.  I know this is alot of meds but we have had a hard time getting everything together.  Research has shown that children who have bipolar family members(past generations) usually have more problems.  I think I've traced it from my maternal grandfather(possibly several of his brothers), uncles, cousins and 1 cousin's child.  I hope as he gets older, things will calm down and we can take him off some meds.

[stirling]

Thank you for your reply! It helps to see how someone elce is handling it all. That is alot of meds. God bless you and your family. I'm reading the Bipolar child and I dont really feel my son fits the profile. Hes more ODD but the book says they are really one and the same. His Dr. just put him on 150mg of wellbutrin and he's been on 20mg of Aderall. I took him off of the zyprexa 4 days before he started the wellbutrin because I couldnt get him to stop eating! He doesnt really have fits just more anger and hatefull most of the time. Doesnt want to follow any of our rules. He also likes this girl that is TROUBLE and cant get him away from her. The doctor wants to put him on a mood stablizer if the wellbutrin doesnt help. I'm kind of afraid to do that but if it will help. I just feel like I'm druging this boy. Would like to exchange e-mail address if you would like to keep in touch. Good Luck

[kidcare]

U can e-mail me at dccompton_286***@****

[Orchidloverforever]

My son is 26 years old but was not finally diagnosed with bipolar until he was 20 years.  I can now look back and see that he,like so many children, was mislabeled as a child.  He has not been able to find any relief to his mania anger, fits or the depression that follows.  

Do you think that Strattera might help?  In reading about this medication, I have wondered several times.  He has been on just about every medication prescribed for bipolar without relief of his symptoms.  I really don't know which is worse - the mania or depression.

Does anyone have any experience with bipolar adults who also have the symptoms of ADHD?